Healthcare Provider Details

I. General information

NPI: 1750607057
Provider Name (Legal Business Name): FAMILY & COMMUNITY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2010
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E MARKET ST
WARREN OH
44481-1141
US

IV. Provider business mailing address

150 E MARKET ST
WARREN OH
44481-1141
US

V. Phone/Fax

Practice location:
  • Phone: 330-394-6244
  • Fax: 330-394-6233
Mailing address:
  • Phone: 330-399-6451
  • Fax: 330-394-6029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK A FRISONE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 330-297-7027